A reader commented:"In the October issue of PIR(3:121, 1981), in "Necrotizing Entercolitis" Burg and Polin recommend partial exchange transfusion for high hematocrit, using normal saline. I was taught to use fresh frozen plasma or albumin for partial exchanges. What are the advantages, if any, of isotonic saline over plasma or albumin?"
Drs Burg and Polin reply: "Although, theoretical arguments can be made for use of fresh frozen plasma to reduce the hematocrit, either saline, synthetic plasma expanders, or 5% albumin would be suitable. Much of the albumin given in plasma or synthetic solutions quickly leaks out of the newborn infant's intravascular compartment. The purpose of a partial exchange transfusion in neonatal polycythemia is to lower the hematocrit and lessen the hyperviscosity; it is not to replace coagulation or immune factors or remove toxins. Saline would be just as satisfactory as plasma for this purpose."
